Operator Chair Positions 27275k

Patient and operator positions

CONTENTs • HISTORY • INTRODUCTION • DENTAL CHAIR AND PATIENT POSTIONS • OPERATOR POSITIONS • OPERATING STOOLS • GENERAL CONSIDERATIONS

INTRODUCTION 

Until a few decades ago , most dental procedures were performed with patient seated upright and dentist standing next to patient ,this prolonged period caused musculoskeletal disorders for dentists.



The role of Ergonomics in dentistry can avoid these occupational hazards .

 Proper positioning of the patient and

operator, illumination and retraction for optimal visibility are fundamental pre requisites to proper dental treatment

Dental chair and patient position  Modern dental chairs are

designed to provide to provide total body in any chair position.

 The patient head is

ed by a head rest cushion which elevates the chin and thus reducing strain on neck

For operative dental procedures , the

patient may be seated in one of the following positions: 1.Almost supine 2.Reclined 45 degrees

1. ALMOST SUPINE POSITION:  In this position the chair is tilted so

that the patient is almost in a lying down posture  The patient’s head ,knees and feet are

approximately at the same level  The head should not be positioned

below the feet level as blood pressure increases gradually

2. RECLINED 45 DEGREE POSITION:  In this position the chair is reclined at 45

degrees so that when the patient is seated, the mandibular occlusal surfaces are almost at 45 degrees to the floor  Once the treatment is over the chair is

brought back to upright position so that the patient can leave the chair easily

POSITONS OF THE OPERATOR

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Forearm parallel to the floor

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Thighs parallel to the floor

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Hip angle of 90 degrees

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Seat height positioned low enough so that the heels of your feet touch the floor

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When working from clock positions 9-12:00, feet spread apart so that your legs and the chair base form a tripod which creates a stable position

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Avoid positioning your legs behind the patient’s chair

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Back of the operator should be always straight

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Head erect and should not be bent of drooping

Operator position:

The main thing which we have to consider are the Operator Position 

Correct positioning of the operator is very important to operator to have good visibility and accessibility to oral cavity.

 FOR A RIGHT HANDED OPERATOR:

1.

Right front or 7’o clock position

2.

Right or 9’o clock position

3.

Right rear or 11’o clock position

4.

Direct rear or 12’oclock position

RIGHT FRONT POSITION:  This is convenient for examination and

working on the mandibular anterior teeth ,mandibular right posterior teeth and maxillary anterior teeth

RIGHT POSITION :  The operator is directly to the right of the patients.  The position is convenient for operating on the facial surface of the maxillary & mandibular right posterior teeth & occlusal surface on mandibular right posterior teeth .  Pen grasp is used for this position.

RIGHT REAR POSITION:  From this position the dentist can

have good access to most areas of the mouth using direct or indirect vision. The dentist sits to the right and slightly behind the patient and the left arm is positioned around the patient’s head  In this position working on the

lingual surfaces of maxillary anterior teeth is most convenient.

DIRECT REAR POSITION :

 Here the dentist sits directly

behind the patient and looks down over the patient’s head  This position is mainly used

only for working on lingual surfaces of mandibular anterior teeth , lingual surfaces of maxillary anterior teeth.

Operator stools:  The design of the stool is important.  It should be sturdy and well balanced

to prevent tipping/gliding away from dental chair  It should be well padded with cushion

edges and should be adjusted up and down  A well designed stool increases

operator comfort and reduces fatigue

LIGHTING;  The operator should be well

illuminated either by natural or artificial light.  If the light is kept too close , it

impairs the physical movement of operator & also increases patient discomfort due to heat production.  If the light is kept far away, it

reduces the illumination.  As a rule for mandibular arch the

light is kept in a higher position & for maxillary arch it is kept in a lower position.

general considerations: 

The patient’s head should be rotated according to need of operator without hesitation



During working maxillary occlusal surfaces should be perpendicular to the floor and for mandibular occlusal surface should be 45 degrees

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The operator should maintain space between the patient as while reading a book

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There should be reduced with that of patient

a)

The operator should never rest his hand on patient’s face

b)

The chest of patient should never be used as trays to keep instruments

)

The left hand should be kept free to retract using the mouth mirror

DON’TS:

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